Holm L, Morsing P, Casellas D, Persson A E
Department of Physiology and Medical Biophysics, University of Uppsala, Sweden.
Acta Physiol Scand. 1990 Mar;138(3):395-401. doi: 10.1111/j.1748-1716.1990.tb08862.x.
Both a myogenic response and the tubuloglomerular feedback control mechanism seem to be involved in autoregulation of glomerular filtration rate (GFR) and renal blood flow (RBF). Earlier experiments have shown that clamping of renal arterial perfusion pressure, below the autoregulatory range, reduces single-nephron GFR, and that this low value is maintained during the first 10-15 min after release of the clamp. It was also found that the tubuloglomerular feedback mechanism in the early declamp phase was strongly activated to reduce GFR. These findings can not be easily understood with the current knowledge of autoregulation, but would suggest a resetting of RBF and GFR autoregulation to a new level. To test this, left renal arterial perfusion pressure was reduced from 100 to 60 mmHg during 20 min with and without angiotensin converting enzyme inhibition (0.5 mg i.v. enalapril). Renal blood flow was measured with laser-Doppler flowmetry. When arterial perfusion pressure was reduced from 100 to 60 mmHg for 20 min, RBF was reduced to 77% of control and remained at this low level during the first minutes of declamp. In this situation there was an autoregulation to a new level. Renal blood flow was then slowly normalized (16.1 min). In the enalapril-treated animals RBF was only reduced to 85% during the 20 min of clamping and returned immediately to the control level at declamp. Thus, these experiments demonstrate that if renal blood flow is decreased by reducing the perfusion pressure below the normal autoregulatory range the pressure range for blood flow autoregulation resets to a lower level and that this change is mediated via the renin-angiotensin system.
肌源性反应和肾小管-肾小球反馈控制机制似乎都参与了肾小球滤过率(GFR)和肾血流量(RBF)的自身调节。早期实验表明,将肾动脉灌注压钳夹至自身调节范围以下,会降低单肾单位GFR,并且在松开钳夹后的最初10 - 15分钟内,该低值会持续存在。还发现,在早期松开钳夹阶段,肾小管-肾小球反馈机制被强烈激活以降低GFR。根据目前对自身调节的认识,这些发现难以轻易理解,但这表明RBF和GFR自身调节被重置到了一个新水平。为了验证这一点,在有和没有血管紧张素转换酶抑制(静脉注射0.5毫克依那普利)的情况下,在20分钟内将左肾动脉灌注压从100毫米汞柱降至60毫米汞柱。用激光多普勒血流仪测量肾血流量。当动脉灌注压在20分钟内从100毫米汞柱降至60毫米汞柱时,RBF降至对照值的77%,并在松开钳夹后的最初几分钟内维持在这个低水平。在这种情况下,存在对新水平的自身调节。然后肾血流量缓慢恢复正常(16.1分钟)。在接受依那普利治疗的动物中,在钳夹的20分钟内,RBF仅降至85%,在松开钳夹时立即恢复到对照水平。因此,这些实验表明,如果通过将灌注压降至正常自身调节范围以下来降低肾血流量,血流自身调节的压力范围会重置到较低水平,并且这种变化是通过肾素-血管紧张素系统介导的。